March 17, 2016
When you're rushed to the hospital by ambulance and your health plan includes ambulance service- your insurance typically covers most of the bill. But if the emergency requires an air ambulance - you could be on the hook for thousands of dollars. It's a growing concern nationwide. Air ambulance charges have been going up while many insurance companies are cutting back on what they'll pay.
Paul Stumbaugh of Sequim, Washington knows the air ambulance dilemma all too well. He survived the scare of his life after leaving work feeling ill. His wife called 911. Ground ambulance crews rushed him to Olympic Medical Center in Port Angeles, a 20 minute drive away. Once there, doctors determined his condition dire enough to need air transport across Puget Sound to U-W Medicine in Seattle.
"The main valve to his heart that pumps the blood over was torn in four places," explained Paul's wife Bridget. " It was leaking."
The couple is quick to emphasize that flight undoubtedly saved precious time, and Paul's life. But the couple was blindsided by the initial airlift charges of nearly $27,000.
"The first thing that went through my mind was bankruptcy," said Paul's wife Bridget.
The insurance company eventually covered pay half that original charges leaving the Stumbaughs with the balance of roughly $13,000.
Air ambulance sticker shock is hitting patients across the country. Physicians make the decision- but unless you're on medicare or medicaid- you get billed for what insurance won't pay. The bill you get depends on the distance of the flight. The company's pricing policy and your insurance company.
Since medical air transport fees are not regulated, companies can charge whatever they want. Some companies are profit-based. Others, including AirLift Northwest which flew Paul Stumbaugh- operate on a not-for profit basis. AirLift Northwest is owned by UW-Medicine.
"To provide the services we provide, it's expensive," said AirLift Northwest Executive Director Chris Martin. Martin says part of the expense for all companies is keeping aircraft staffed and ready for lift off. Unlike profit-based companies, Martin says AirLift Northwest strives to keep prices in the mid to low range of it's Northwest competitors- and they work with patients who struggle financially.
"We pride ourselves in working with those family members and with those patients to make sure that they don't suffer a hardship." ,said Martin. According to UW Medicine, Airlift Northwest does $5.8 million in charity care and write-offs.
The Stumbaughs feel insurance companies bear part of the blame, saying Paul's policy covered ambulance service. To them, ambulance means any ambulance.
"When you put your time and effort in to find an insurance company that's going to meet your needs- that's what you depend on," said Bridget.
Insurance companies blame unregulated operators for the high prices. The air ambulance industry points right back- saying insurance reimbursement is not adequate to cover costs. Some states and members of congress are pushing for the government to get involved in the pricing and reimbursement debate.
One solution for consumers is to sign up for an air transport membership that covers what your insurance won't. Many air ambulance companies have them. AirLift Northwest says its plan, called AirCare, covers your entire family for $79 a year. It's 14-thousand members live in the San Juan Islands and other remote areas where health emergencies make time of the essence.